What Is Kerendia?

Kerendia (Finerenone) is a non-steroidal mineralocorticoid receptor antagonist (MRA) manufactured by Bayer Healthcare. It is FDA-approved to reduce the risk of kidney function decline, kidney failure, cardiovascular death, non-fatal heart attacks, and hospitalization for heart failure in adults with chronic kidney disease (CKD) associated with type 2 diabetes. It is also approved to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure and a left ventricular ejection fraction of 40% or greater (HFpEF/HFmrEF).

How does Kerendia work?

Kerendia works by blocking the activity of mineralocorticoid receptors in the body. When these receptors are overactivated — which commonly occurs in patients with CKD and type 2 diabetes — they drive inflammation and fibrosis (scarring) in the kidneys and heart. By selectively blocking these receptors, Finerenone reduces this harmful inflammation and scarring, helping to slow kidney disease progression and lower cardiovascular risk. Unlike older MRAs such as Spironolactone, Kerendia is non-steroidal, which means it has a more targeted mechanism and fewer hormonal side effects.

What doses are available for Kerendia?

• 10 mg film-coated tablet
• 20 mg film-coated tablet

Starting dose depends on kidney function (eGFR): 10 mg daily for eGFR 25 to less than 60, and 20 mg daily for eGFR 60 or higher. The target dose is 20 mg once daily.

How hard is it to find Kerendia in stock?

Kerendia (Finerenone) is a brand-name specialty medication with no generic equivalent. It is not currently listed on the FDA Drug Shortage database and has not experienced significant supply disruptions since its approval in July 2021. However, because it is a single-source specialty product, not all pharmacies routinely stock it. Patients may need to check specialty or larger chain pharmacies. Using Medfinder can help locate pharmacies that have Kerendia available near you.

Who Can Prescribe Kerendia?

Kerendia is most commonly prescribed by nephrologists, endocrinologists, and cardiologists. Internal medicine physicians and primary care or family medicine doctors may also prescribe it, particularly when managing patients with both type 2 diabetes and chronic kidney disease. Telehealth consultations are available for Kerendia prescriptions.

Is Kerendia a controlled substance?

No. Kerendia is not a controlled substance and does not have a DEA schedule. It does not carry a risk of abuse or dependence, and no special prescribing restrictions apply beyond standard prescription requirements.

Common Side Effects of Kerendia

• Hyperkalemia (high potassium levels) — the most common and important side effect; regular blood monitoring is required
• Hypotension (low blood pressure)
• Hyponatremia (low sodium levels)
• Dizziness or feeling faint

Serious side effects may include severe hyperkalemia causing heart palpitations, irregular heartbeat, muscle weakness, or numbness, as well as severe hypotension or hyponatremia. Contact your doctor immediately if you experience any of these symptoms.

Alternative Medications to Kerendia

• Spironolactone — A steroidal mineralocorticoid receptor antagonist available as an affordable generic. It is widely used but has more side effects such as gynecomastia and sexual dysfunction due to cross-reactivity with androgen and progesterone receptors.
• Eplerenone — Another steroidal MRA with better selectivity than Spironolactone but less potent. Available as a generic, primarily indicated for heart failure and hypertension.
• Dapagliflozin (Farxiga) — An SGLT2 inhibitor approved for CKD with or without diabetes. Different mechanism but also provides kidney and heart protection.
• Empagliflozin (Jardiance) — An SGLT2 inhibitor with CKD and heart failure indications, often used alongside or as an alternative kidney-protective therapy.

Drug Interactions with Kerendia

• Strong CYP3A4 inhibitors (Itraconazole, Ketoconazole, Ritonavir, Clarithromycin, Voriconazole) — contraindicated, do not use together
• Strong CYP3A4 inducers (Rifampin, Carbamazepine, Phenytoin, St. John's Wort) — avoid, as they significantly reduce Kerendia's effectiveness
• Moderate CYP3A4 inhibitors (Erythromycin, Diltiazem, Verapamil, Fluconazole) — dose adjustment may be needed
• Potassium supplements and potassium-sparing diuretics — increased risk of dangerous hyperkalemia
• NSAIDs — may increase potassium levels and reduce kidney function
• Grapefruit and grapefruit juice — avoid, as they increase Finerenone levels in the blood

Final Thoughts on Kerendia

Kerendia represents an important advance in treating chronic kidney disease associated with type 2 diabetes and heart failure with preserved ejection fraction. As a non-steroidal MRA, it offers a more targeted approach with fewer hormonal side effects compared to older alternatives like Spironolactone. While the cash price of $670–$950 per month is significant, Bayer's Savings Card can reduce costs to $0 for commercially insured patients, and patient assistance programs are available for uninsured or underinsured individuals. The main consideration is regular potassium monitoring due to the risk of hyperkalemia. If you're having trouble finding Kerendia at your local pharmacy, try using Medfinder to locate it in stock near you.